High uric acid levels, known as hyperuricemia, occur when your body produces excess uric acid or your kidneys struggle to eliminate it. This can trigger gout, a painful condition with swollen joints, often in the big toe, caused by uric acid crystal deposits. But what causes these levels to rise? How can you spot the signs, and what steps can you take to manage it?

Dr. Shakeel Rahman, General Physician in Patna, Bihar. Dr Rahman breaks down how high uric acid is identified, its effects on the body, and practical management strategies. 

Excerpts from the conversation:

First Check: How can someone tell that they have high uric acid levels?

Dr Shakeel Rahman: High uric acid levels sometimes are diagnosed during routine investigation. Sometimes they’re diagnosed when a patient has joint pains, especially affecting smaller joints of the body, and the most common site is the base of the big toe in the feet. In that case, it becomes gout arthritis because the uric acid is deposited there. You get a swollen, red, tender joint, making the patient unable to walk. This is the most common symptom, but it’s not the only presentation of gout arthritis. Sometimes, when you’re doing a routine investigation, like a renal function test, you also check uric acid levels. So, it may show up as symptomless high uric acid or as gout arthritis with symptoms.

What actually happens to the body when uric acid levels are high, and how does it happen?

Uric acid gets deposited in the joints in the form of crystals. It’s supposed to be secreted through the kidneys, but when kidney function is compromised for any reason, uric acid levels go high. That’s when it can form crystals and get deposited in the joints. That’s why it needs to be treated, whether it’s showing up as part of a renal function test or causing joint pain, what we call monoarthritis—pain in a single joint, usually.

Does high uric acid show that there’s some malfunctioning of the kidney, and can it also indicate kidney stones?

Not necessarily. Sometimes kidney functions are perfectly alright, and the patient still has gout arthritis. Uric acid can be singularly raised, irrespective of other renal function test results. So, it doesn’t always mean kidney issues or kidney stones.

Does this commonly happen in any particular season?

No, no. There’s no seasonality. It does have some relation with food, though, especially with gout arthritis. We say to avoid red meat if you have gout arthritis because red meat has a high percentage of uric acid.

What could trigger it in vegetarians?

This could even be genetic. There are some genes responsible for high uric acid levels. It’s like hyperlipidemia—sometimes your cholesterol and triglycerides are very high, even if you’re eating a very spartan diet, like only dry chapati and wild vegetables. You can still have high levels because it’s genetic or familial.

How can one keep uric acid levels in check, and what should you do when levels are very high?

Doctors will often prescribe medicines (like ibuprofen and naproxen) for that. There are specific medicines that need to be taken to control uric acid levels. That, along with diet control, is usually enough. All foods that are not rich in uric acid (vegetables, legumes, and beans) can be taken. The only thing we ask is not to take red meat.

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